acenocoumarol and Hyperlipidemias

A 67-year-old man receiving a stable maintenance dosage of warfarin experienced an increased international normalized ratio (INR) without bleeding when his atorvastatin therapy was switched to fluvastatin. His warfarin dosage was reduced and his INR stabilized. The fluvastatin was switched back to atorvastatin, and the warfarin dosage was increased to maintain the patient's goal INR. The literature supports a drug interaction between warfarin and fluvastatin due to the strong affinity of fluvastatin for the cytochrome P450 enzyme 2D6. This interaction has not been seen with atorvastatin. Lovastatin also reportedly has caused increases in INR when coadministered with warfarin. It is unclear whether simvastatin interacts with warfarin, but it may increase INRs slightly or increase serum simvastatin levels. One case report describes an interaction between simvastatin and the anticoagulant acenocoumarol, which resulted in an elevated INR. Pravastatin does not appear to interact with warfarin but has caused an increased INR when combined with the anticoagulant fluindione. Thus, until more definitive data are available, clinicians should monitor the INR closely after starting statin therapy in any patient receiving anticoagulation therapy.

Topics: Acenocoumarol; Administration, Oral; Aged; Anticoagulants; Atorvastatin; Drug Interactions; Fatty Acids, Monounsaturated; Fluvastatin; Heptanoic Acids; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hyperlipidemias; Indoles; International Normalized Ratio; Male; Patient Compliance; Pyrroles; Simvastatin; Venous Thrombosis; Warfarin

Topics: Acenocoumarol; Administration, Oral; Anticoagulants; Aortic Aneurysm; Brain Ischemia; Cyanosis; Heparin; Humans; Hyperlipidemias; Hypertension; Male; Middle Aged; Myocardial Infarction; Risk Factors; Thromboembolism; Thrombosis; Toes; Urinary Bladder Neoplasms

Although the indications for oral anticoagulation (AO) in the treatment of cerebral vascular disease (CVD) are well established, their potential side effects continue to give cause for worry.. To describe the complications and ischemic relapses in patients treated with AO for secondary prevention of CVD of cardiac embolic origin.. We included 169 patients with embologenic cardiopathy who, following an CVD, were treated with AO and followed-up at our medical centre for at least three months. We recorded their past clinical history and risk factors, occurrence of vascular relapses (VR), complications involving hemorrhage (CH), and data regarding course and follow-up.. During an average follow-up of 50.3 months of a total of 707.9 patient/years, 20 VR (2.8% per year) were recorded; 15 of these were cerebro-vascular and mainly mild. We recorded 59 CH in 41 patients (8.3% per year) of which 6 were considered to be major. There was a 30% drop-out rate from follow-up at our centre, mainly due to death from other causes or to change of referral centre.. There is a low incidence of relapse and of complications (usually mild) following AO for the secondary prevention of CVD of cardio-embolic origin. Efficacy and security are maintained in the long term.

Topics: Acenocoumarol; Administration, Oral; Alcoholism; Anticoagulants; Arteriosclerosis; Atrial Fibrillation; Cardiomyopathy, Dilated; Cohort Studies; Comorbidity; Diabetes Mellitus; Disease-Free Survival; Follow-Up Studies; Heart Valve Diseases; Hemorrhage; Humans; Hyperlipidemias; Hypertension; Intracranial Embolism and Thrombosis; Life Tables; Myocardial Infarction; Recurrence; Risk Factors; Smoking; Spain; Treatment Outcome

Topics: Acenocoumarol; Adenine Nucleotides; Aniline Compounds; Animals; Anticoagulants; Blood Coagulation; Blood Platelets; Drug Synergism; Endotoxins; Hyperlipidemias; Oxyphenbutazone; Phenylacetates; Phenylbutazone; Platelet Adhesiveness; Rats; Sulfinpyrazone; Thrombin; Thrombosis

Topics: Acenocoumarol; Anticoagulants; Budd-Chiari Syndrome; Endotoxins; Escherichia coli Infections; Heparin; Hirudins; Hyperlipidemias; Pharmacology; Prothrombin Time; Rats; Research; Salmonella Infections; Salmonella Infections, Animal; Thrombophlebitis; Toxicology; Venous Thrombosis